Efficacy and Safety of Tolvaptan in Cirrhotic Patients With Hyponatremia (OASIS)

Capital Medical University

Status: Completed

Conditions: Liver Cirrhosis; Hyponatremia

Treatments: Other: conventional thearpy; Drug: Tolvaptan

Study type: Observational

Funder types: Other

Identifiers

NCT01850940

OASIS

Details and patient eligibility

About

This is a phase IV, open-label, prospective cohort study for 7 days.The recommended starting dose of tolvaptan is 15 mg daily orally. The dose may be titrated on the next day at 15 mg intervals up to 60 mg daily according to the serum sodium level response.Serum sodium level, change in sodium level from baseline, quality of life (EQ-5D-3L), change in body weight, edema, renal function, mortality and liver-related complications on day 7 and day 30 to evaluate the efficacy of tolvaptan in cirrhotic patients with hyponatremia.

Full description

Tolvaptan is an effective treatment for hyponatremia. However, cirrhotic patients were underrepresented in previous studies. The pattern of use and efficacy of tolvaptan in real-life clinical practice are currently unknown.The objective of this study is to evaluate the efficacy of tolvaptan in cirrhotic patients with hyponatremia. The secondary objective is to evaluate the short- to intermediate-term safety of tolvaptan in cirrhotic patients.This will be a phase IV, open-label, prospective cohort study for 7 days. Although not mandatory, study subjects are encouraged to undergo follow-up assessments at 1 month.Subjects will be evaluated at designated time points after initiation of therapy. The primary efficacy endpoint is the proportion of subjects with normal serum sodium level (135-145 mmol/l) on day 7. The secondary efficacy endpoints are serum sodium level, change in sodium level from baseline, quality of life (EQ-5D-3L), change in body weight, edema, renal function, mortality and liver-related complications on day 7 and day 30.

Enrollment: 98 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age no less than 18 years;
2. Confirmed cirrhosis by histology or radiological features of cirrhosis and clinical features of portal hypertension;
3. Serum sodium level less than 135 mmol/L;
4. Inpatients.

Exclusion criteria

1. Clinical features of hypovolemia;
2. Systolic blood pressure less than 90 mmHg;
3. Life expectancy less than one month;
4. History of variceal bleeding in the last six months;
5. Hepatic encephalopathy or peritonitis in the last two weeks;
6. Serum creatinine more than 3.5 mg/dl;
7. Severe cardiopulmonary disease;
8. Urinary tract obstruction.

Trial design

98 participants in 2 patient groups

Tolvaptan Group

Description:

Tolvaptan,qd, po

Treatment:

Drug: Tolvaptan

Conventional therapy

Description:

control group:Conventional therapy without tolvaptan

Treatment:

Other: conventional thearpy